RSV Infections: What Parents and Older Adults Need to Know About Risks and Prevention

Every winter, a quiet but powerful virus sweeps through homes, hospitals, and daycare centers. It starts with a runny nose, a cough, maybe a fever. For most adults, it’s just a cold. But for infants and older adults, it can turn deadly. This virus is RSV - Respiratory Syncytial Virus - and it’s not something you can ignore.

What Is RSV, Really?

RSV isn’t new. Scientists first isolated it in 1956, but it’s only in the last few years that we’ve fully understood how dangerous it can be. It’s a common virus that attacks the respiratory tract - from the nose all the way down to the lungs. In healthy kids and adults, it usually causes mild cold symptoms: stuffy nose, sore throat, cough, maybe a low fever. But for babies under 1 year and people over 65, it can quickly become life-threatening.

RSV spreads easily. You can catch it from someone coughing or sneezing nearby. You can pick it up from a doorknob, a toy, or a shopping cart if someone with RSV touched it earlier. The virus can live on surfaces for up to 10 hours. And once infected, you’re contagious for 3 to 8 days - longer if you’re an infant or have a weak immune system.

Why Are Infants at Such High Risk?

Babies under 6 months are the most vulnerable. Their airways are tiny. Even a little bit of swelling or mucus can block their breathing. That’s why RSV is the #1 cause of bronchiolitis (inflammation of the small airways) and pneumonia in infants under 1 year.

About 2 to 3% of babies under 6 months end up in the hospital each year because of RSV. In the U.S. alone, that’s 58,000 to 80,000 hospitalizations for kids under 5. Globally, RSV leads to over 3.6 million hospitalizations and around 100,000 deaths in children under 5 every year - and 97% of those deaths happen in countries where oxygen, IV fluids, or ventilators aren’t always available.

Some babies are at even higher risk:

• Preterm babies (born before 29 weeks) - 3 to 5 times more likely to be hospitalized
• Babies with congenital heart disease - 20 to 25 times higher risk of severe illness
• Children with chronic lung disease - 10 to 15 times more likely to need intensive care

Signs of trouble in infants include:

• Fast, shallow breathing - more than 60 breaths per minute
• Chest pulling in with each breath (retractions)
• Noisy breathing or wheezing
• Poor feeding - taking less than half their usual amount
• Lethargy - unusually sleepy, hard to wake up

If you see any of these in your baby, don’t wait. Get help right away.

Why Older Adults Are in Danger Too

For years, RSV was seen as a “kids’ virus.” But since 2020, doctors have been sounding the alarm: older adults are dying from it in alarming numbers.

In the U.S., RSV sends 60,000 to 160,000 adults over 65 to the hospital each year. About 6,000 to 14,000 die. That’s more than the flu kills in many years.

It’s not just age - it’s what comes with it. As we get older, our immune systems weaken. That makes it harder to fight off infections. And if you already have heart or lung problems, RSV can push your body over the edge.

People with COPD are 4.2 times more likely to be hospitalized with RSV. Those with heart failure face 2.8 times higher risk. Adults over 75 stay in the hospital nearly 3 times longer than younger adults and are almost twice as likely to die.

And the damage doesn’t end when you leave the hospital. Nearly half of older adults who are hospitalized with RSV develop new problems - trouble bathing, dressing, or walking. About 28% need to go to a rehab center or nursing home after recovery.

How RSV Changes Your Health Long-Term

Many people think once you recover from RSV, you’re fine. But that’s not true - especially for babies.

Children who were hospitalized with RSV bronchiolitis before age 2 are more than four times as likely to develop asthma by age 7. Studies show their lungs never fully catch up. Even into their teens, these kids have lower lung function - about 8 to 12% below normal.

For older adults, severe RSV can trigger a downward spiral. One infection can lead to long-term weakness, reduced mobility, and increased risk of future infections. It’s not just a cold - it’s a major health event.

Prevention: What Actually Works

The good news? We now have powerful tools to stop RSV before it starts.

For Infants: Nirsevimab (Beyfortus™)

In July 2023, the FDA approved a game-changer: nirsevimab, a single-shot monoclonal antibody given to babies before or during RSV season. It doesn’t prevent infection - but it prevents serious illness. In clinical trials, it cut the risk of hospitalization by 75% for the first 5 months of life.

The CDC now recommends it for all infants under 8 months entering their first RSV season. Babies 8 to 19 months with high-risk conditions (like prematurity or lung disease) should get it too, even in their second season.

For Older Adults: RSV Vaccines

For the first time ever, two RSV vaccines are available for adults 60 and older:

• GSK’s Arexvy - 82.6% effective at preventing lower respiratory tract disease
• Pfizer’s Abrysvo - 66.7% effective

Both were approved in May 2023. The CDC recommends shared decision-making: talk to your doctor about your health, risk factors, and whether the vaccine is right for you. It’s especially important if you have heart disease, COPD, or live in a nursing home.

For Everyone: Simple, Proven Steps

Even with new tools, basic hygiene still saves lives:

• Wash hands with soap for at least 20 seconds - it cuts transmission by up to 50%
• Avoid touching your face - especially eyes, nose, and mouth
• Disinfect high-touch surfaces daily - doorknobs, phones, toys, counters - with EPA-approved cleaners
• Stay home if you’re sick - even with mild symptoms
• Keep babies away from crowded places during RSV season (late fall to early spring)

And if you’re pregnant? Pfizer’s Abrysvo is now approved for use between 32 and 36 weeks of pregnancy. It passes protective antibodies to your baby before birth, reducing severe RSV in newborns by 81.8% for the first 6 months of life.

What’s Still Missing

These tools are powerful - but not equal. In the U.S., nirsevimab and RSV vaccines are available in most clinics and pharmacies. But in low-income countries, access is nearly zero. The cost of one dose of Arexvy is $295 in the U.S. - far beyond what families in rural Kenya or Papua New Guinea can afford.

That’s why global health experts warn: without fair access, we’ll keep seeing 97% of RSV deaths in places with the least resources. That’s not just a health issue - it’s a justice issue.

What You Should Do Now

If you have a baby under 1 year:

• Ask your pediatrician about nirsevimab - it’s free or low-cost for most families in the U.S.
• Wash hands before touching your baby
• Keep visitors away if they’re sick
• Know the warning signs: fast breathing, poor feeding, lethargy

If you’re over 65:

• Ask your doctor about the RSV vaccine
• Get it before RSV season starts - usually October
• Don’t wait until you’re sick - prevention is the only real defense

If you’re pregnant:

• Ask about Abrysvo between 32 and 36 weeks
• It protects your baby before they’re even born

RSV isn’t going away. But now, we have the tools to stop it from killing our most vulnerable people. The question isn’t whether we can prevent it anymore. The question is: will we?